Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Br J Ophthalmol. 2014 Nov;98(11):1551-4. doi: 10.1136/bjophthalmol-2013-304393. Epub 2014 Jun 25.
BACKGROUND/AIMS: To examine the relationship between change in optic nerve head (ONH) morphology and retinal blood flow in patients with open-angle glaucoma (OAG) of African (AD) and European descent (ED) over 3 years.
112 patients with OAG (29 AD; 83 ED) underwent assessment of ONH morphology using Heidelberg retinal tomography (HRT-III), and retinal blood flow using confocal scanning laser Doppler. Repeated-measures analysis of covariance was used to compare baseline and 3-year measurements, and Pearson correlations were calculated to evaluate the relationships.
In OAG patients of AD, change in superior mean retinal blood flow was strongly, negatively correlated with change in cup/disc (C/D) area ratio (r=-0.78, p=0.020) and cup area (r=-0.75, p=0.0283) and strongly, positively correlated with change in rim area (r=0.74, p=0.0328) over 3 years. In OAG patients of AD, change in inferior mean retinal blood flow was strongly, negatively correlated with changes in C/D area ratio (r=-0.88, p=0.0156) and linear C/D ratio (r=-0.86, p=0.0265) over 3 years. In OAG patients of ED, these correlations were weak and did not reach statistical significance.
OAG patients of AD may have a stronger vascular component to their glaucoma pathophysiology than patients of ED.
背景/目的：检查非洲裔（AD）和欧洲裔（ED）开角型青光眼（OAG）患者 3 年内视神经头（ONH）形态变化与视网膜血流之间的关系。
112 例 OAG 患者（29 例 AD；83 例 ED）接受了海德堡视网膜断层扫描（HRT-III）评估 ONH 形态，并使用共焦扫描激光多普勒检查视网膜血流。采用重复测量协方差分析比较基线和 3 年的测量值，并计算 Pearson 相关系数评估相关性。
在 AD 型 OAG 患者中，上平均视网膜血流的变化与杯/盘（C/D）面积比（r=-0.78，p=0.020）和杯面积（r=-0.75，p=0.0283）的变化呈强烈负相关，与边缘面积（r=0.74，p=0.0328）的变化呈强烈正相关，3 年内均呈负相关。在 AD 型 OAG 患者中，下平均视网膜血流的变化与 C/D 面积比（r=-0.88，p=0.0156）和线性 C/D 比（r=-0.86，p=0.0265）的变化呈强烈负相关，3 年内均呈负相关。在 ED 型 OAG 患者中，这些相关性较弱，且未达到统计学意义。
AD 型 OAG 患者的青光眼病理生理学可能比 ED 型患者具有更强的血管成分。
